title: Prediction of left ventricular remodeling in patients with STEMI treated with primary PCI: use of quantitative myocardial contrast echocardiography.
abstract: OBJECTIVE
  We sought to determine the frequency of left ventricular remodeling in the 6-month follow-up after anterior ST elevation myocardial infarction and the value of quantitative parameters of perfusion contrast echocardiography for prognosis of left ventricular remodeling against other established risk.
  
  
  METHODS
  A total of 60 patients with anterior ST elevation myocardial infarction treated by primary percutaneous intervention were examined. In 28 patients, thromboaspiration was performed before stent implantation with Driver catheter. Before and after successful angioplasty, perfusion in myocardial blush grade (MBG) scale was assessed. Various electrocardiogram parameters were analyzed. Resting perfusion with myocardial contrast echocardiography was performed.
  
  
  RESULTS
  Logistic regression has permitted one to conclude that higher value of MBG, higher left ventricular ejection fraction at discharge, and higher value of parameter A at quantitative echocardiography in dysfunctional segments were prognostic for lack of remodeling over 6 months. The receiver operating characteristics curves for parameters of quantitative perfusion echocardiography (A, β, A×β) allowed us to conclude that value A>1.96 dB, value β>0.155 s, and value A×β>0.57 dB/s are optimal cut-off points prognostic for remodeling. Area under the curve was 0.8 for A and 0.85 for β.
  
  
  CONCLUSIONS
  The best predictors of remodeling in 6 months' observation have appeared to be lower left ventricular ejection fraction at discharge, poorer perfusion assessed angiographically (MBG scale), and the rate of signal intensity increase reflecting the mean bubble velocity of the myocardium by contrast as assessed by contrast echocardiography. Quantitative perfusion angiography independently has high predictive value for the development of remodeling in long-term follow-up.
authors.affiliation: First Department of Cardiology, Medical University of Silesia, Katowice, Poland.
authors.forename: Krystian
authors.initials: K
authors.lastname: Wita
authors.forename: Artur
authors.initials: A
authors.lastname: Filipecki
authors.forename: Michał
authors.initials: M
authors.lastname: Lelek
authors.forename: Tomasz
authors.initials: T
authors.lastname: Bochenek
authors.forename: Marek
authors.initials: M
authors.lastname: Elżbieciak
authors.forename: Wojciech
authors.initials: W
authors.lastname: Wróbel
authors.forename: Adrianna
authors.initials: A
authors.lastname: Berger Kucza
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Tabor
authors.forename: Janusz
authors.initials: J
authors.lastname: Drzewiecki
authors.forename: Marek
authors.initials: M
authors.lastname: Grabka
authors.forename: Maria
authors.initials: M
authors.lastname: Trusz Gluza
mesh_terms: D000077284:Abciximab; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D004452:Echocardiography; D005260:Female; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011379:Prognosis; D013318:Stroke Volume; D013396:Suction; D020257:Ventricular Remodeling
chemical_list: D000911:Antibodies, Monoclonal; D007140:Immunoglobulin Fab Fragments; D010975:Platelet Aggregation Inhibitors; D000077284:Abciximab